What is a Root Canal?

Most people will cringe at the mere mention of a root canal, but if it's done right it isn't painful. In fact, if you need a root canal, the irritation in the offending tooth is probably causing you more pain than removing it will. From personal experience, I would say that a root canal is no more painful than having a filling replaced. Having a root canal means your dentist can save the tooth as long as he removes the damaged inner pulp. If he had to remove the entire tooth, your other teeth would shift unless he put in a costly bridge or implant. It's really the lesser of a lot of evils.

A root canal involves four steps.

Understanding the procedure might help take away the fear those two words seem to cause. The reason your dentist decides to do a root canal is because the inner pulp of the tooth is damaged beyond repair.

The first step is for your dentist to remove all of that damaged inner pulp from the chamber of the tooth. He will probably take an x-ray before doing this to be sure you don't have an infection and to check the shape of the root. He'll need to drill an access hole in order to remove all the pulp, nerve and other decayed material.

Step two is to clean and smooth the inside of the tooth. He'll do this with tools called root canal files. They are graduated in size so that the dentist can work them clear to the end of the root and be sure that all of the soft pulp is cleaned out. While he's doing this, water or another sterile fluid will be used to flush out the inside of the tooth.

Step three involves filling the tooth. If you've had an infection, your dentist might want to fill the tooth with a medicated substance and put a temporary cap on the tooth. He might wait up to a week to remove the medicated stuff and replace it with a rubber compound called gutta percha. This is the same substance used to insulate electrical cables and make golf balls. It's used because it doesn't react with other substances and won't cause sensitivity to heat or cold.

Step four is to cover the tooth with a crown. Usually damage to the tooth is too great to use just a filling, so the tooth will probably need a crown to protect what's left of the tooth from further damage.

If I ignore it, will it get better?

If you were to leave the inner pulp and nerve in the tooth, all sorts of horrible things could happen in your mouth. Besides the obvious pain, it could cause your tooth to turn a dark color, the gums around the tooth could get infected, and abscesses could form. Since your tooth doesn't really need the nerve, removing it along with the inner pulp will save you personal pain and money.

If you have a toothache, see a dentist as soon as possible. Here is what could be happening inside that one little tooth: If the inner pulp is damaged, bacteria begin to multiply and cause an infection. If that infection spreads all the way up the root of your tooth, the pus will form an abscess. The abscess will cause pain and swelling in your neck and face.

Do you still think this will go away on its own?

If the pain hasn't caused you to run to the dentist yet, the decay could be causing bone loss around the tip of the root. If the build up of pus is extreme, it will find a way to drain, whether that is through your gums, or even through your cheek and into your skin.

Before a dentist can perform a root canal he needs to clear up the infection and will prescribe oral antibiotics. Medication will take away the pain and swelling as the bacteria are brought back under control.

How did this happen to my tooth?

My sister broke her jaw when she was little and the tiny crack it caused in two of her teeth didn't give her problems until she was an adult. Very slowly, the pulp and nerves became irritated until they started causing pain and she went to the dentist. Athletes should wear mouth guards to avoid trauma to the jaw which might result in the need for root canals in the future. Sometimes lots of work on a tooth will cause damage to the pulp, or a very large filling won't leave a thick enough barrier between the filling and the pulp to avoid irritation.

What you can expect after the root canal is finished

For two or three days, your tooth and the gums around it might be a little sensitive. It's nothing that over-the-counter pain medication won't take care of, though. Try chewing on the other side of your mouth until the area is back to normal. Brush and floss the way you always do and within a week you'll probably forget you ever had a root canal.

Did you really want to know the cost?

Many insurance policies cover root canals, but if yours doesn't, the cost for the root canal alone is between $350 to $540 for an incisor and between $520 to $800 for a molar. That isn't including any sort of tooth restoration or crown. If an endodontist does your root canal, it could be up to 50% more expensive, so it's best to have your dentist do the procedure if he is comfortable with doing it. Sometimes there are complications and your dentist will refer you to the endodontist who is a specialist in human dental pulp or the nerve of the tooth.

Good dental hygiene is the best prevention of root canals which are most often caused by deep decay. Brush your teeth regularly and floss once a day. See your dentist for regular checkups and cleaning.

Sources:
WebMD http://www.webmd.com/oral-health/dental-root-canals
Bellfort Dental Glossary http://www.bellfortdental.com/glossary.htm